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Subscribe to RSSPreventing heart disease is not as easy as brushing your teeth.
While numerous studies have linked gum disease with an increased risk of heart disease and stroke, there is no proof that bad gums actually cause heart disease or strokes, an American Heart Association committee said after reviewing 500 journal articles and studies.
Moreover, claims that dental treatment may prevent heart attack or stroke are unwarranted, the committee of doctors, dentists and infectious-disease researchers said in a statement.
"The message sent out by some in health care professions – that heart attack and stroke are directly linked to gum disease – can distort the facts, alarm patients and perhaps shift the focus of prevention away from well-known risk factors for these diseases," said committee member Dr. Peter Lockhart, a professor of oral medicine at the Carolinas Medical Center in Charlotte, N.C.
It is biologically plausible, the committee acknowledged, that oral bacteria infections could cause heart disease. Mouth bacteria can enter the bloodstream during dental procedures and tooth brushing.
However, gum disease and heart disease share many common risk factors, including cigarette smoking, age and diabetes, and these factors are more likely to explain why diseases of the blood vessels and mouth occur in tandem.
Studies that show a strong relationship between gum disease and heart disease have failed to account for these common factors, the committee said.
"Individuals who do not pay attention to the very powerful and well-proven risk factors like smoking, diabetes or high blood pressure may not pay close attention to their oral health, either," Lockhart said.
One study even found invasive dental procedures, which include some treatments for gum disease, could increase the risk of heart attack and stroke.
A large, long-term study would be needed to prove whether dental disease causes heart disease and stroke, Lockhart said. Such a study isn't likely to be done in the near future, and it's most important to let patients know "what we know now, and what we don't know," he added.
Good oral hygiene is still important for overall health, and some studies show treatment of gum disease reduces markers of inflammation in the body, the committee said.
The committee statement will be published in the journal Circulation. It was endorsed by the American Dental Association Council on Scientific Affairs and the World Heart Federation.
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Funny that I work in a Heart Surgery ICU and the majority of patients needing surgery have bad teeth...Some are so bad they need a full mouth extraction prior to their heart surgery. And many of the valve replacements are directly related to poor dentation. Sounds like a Democrat ploy to get less heart surgery on older patients!
Didn't read the article did you? There is only one thing worse than the "observational analysis" published by physicians and that is anecdotal junk analysis based on a lack of first hand experience but put out there anyway by self-described experts on everything such as yourself. Your rant is a perfect example of why people in the for-profit medical industry should NOT be involved in research. Bias.
Actually, I wouldn't say "funny" --- I would say "tragic."
Perhaps bad teeth are not the cause of poor cardio health. Perhaps poor gums and teeth are the result of heart disease and circulatory issues.
Or neither is causal of either... just correlated.
It could just be that people, who can't take care of their teeth, simply do not take care of the rest of their body. in other words, they are irresponsible, in general.
Sounds like you've had a full brain extraction, J.
I know surgeons are doctors, but at the end of the day it's a glorified trade school.
Leave research to the research PHD's who actually know the difference between correlation and causation and how to actually test a hypothesis.
My sister is a Physician's Assistant with medical training. I have a liberal arts masters degree. We both have masters degrees. I had tons of reading and notes to study for an exam. She just pulled out her notebook and reviewed her class notes (no reading at all). I agree with your trade school assessment. She has no critical thinking, or debate skills at all. She just processes things. If this and this it could be this....etc. etc. etc..
She does make a butload of money though.
I'll take the experience of someone in the field any day over what some bean counter with a pocket protector and 12 phd degrees because he's too scared to enter the real world.
Just ask Bleeding Gums Murphy, he'll tell you!
Correlation is not causation. I guessed this was the case all along. (Patting myself on the back, yes.)
New theory: People who lack proper oral hygiene also disregard other healthy practices, which could prevent other diseases/conditions.
I've posted this before: I wish I was dumb enough to be a medical researcher. I bet they make good money.
I was going to post exactly the same thing (even the line about correlation is not causation) but it seems you and several others beat me to it.
Anyways, I do agree. It stands to reason that if you do not take the time to brush your teeth, you probably do not care for yourself (or were never taught how to care for yourself) as one should.
The two definitely may be correlated...but the whole causation part is just bad logic. It is like saying...
"A dog is a mammal. My wife is a mammal. Therefore, my wife is a dog." The only place that logic will logically lead you is in the dog house yourself...
Medical school is just a high-stakes trade school. I've met smarter auto mechanics.
Fine. Go to your mechanic the next time you have a heart attack. I'm sure they'll fix you right up.
or better yet, go to your doctor the next time your car breaks down, Im sure they'll fix you right up. Two sides of the same coin, get it?
If you guys are doctors it just goes to show that you can barely interpret what you read.
I said I met _smarter— auto mechanics. I didn't say I know auto mechanics that are more capable in the medical trade.
Although I've learned to go to medical practices that have research functions because you get MD's who know what research means, are able to translate that to an actual physiological process, and are able talk to you like an adult,
Then there's the guy who runs the urgent care clinic who barely touches you and declares a sinus infection allergies - or who will prescribe antibiotics without confirming any kind of bacterial infection - or who prescribes immodium for what turned out to actually be constipation and I wind up in the hospital (which was the last time I went to see him)
It was like he was following a cookbook - bases diagnoses on what 95% of cases would be - rather than what's sitting there.
JRS ...which makes sense, because that's where your wife is anyways. You can both live there and save a ton on rent.
@zupercram,
This has nothing to do with being a "medical researcher." Medical researchers (my wife is one) are PhDs, not MDs. MDs have absolutely no training in medical research and, unless they have acquired the skills outside of their vocational degree, do not possess the skills necessary to design, conduct or evaluate clinical research.
Much of this is what medical schools call "observational analysis." It is closer to the formulation of urban myths than it is to medical research. We have known for 3500 years that we know of the "correlation does not equal causation" but the word had been very slow to reach medical schools. (They are called "schools", not colleges or universities for a reason.) Now we hear that medical schools are using that this "junk research" being "Mentioned in the Press", or MIP'ed as a criteria for promotion similar to journal citations among real researchers.
We need to get physicians' hands OFF research for this BS to stop. It seems like half the legitimate medical research currently going on is trying to "correct" studies done by physicians.
Not long ago a physician made a presentation of "his" research to a conference of physicians in Aruba. One of the physicians present was a geriatrician who noticed a similarity to my wife's work and notified her. She got a copy from the conference web site and lo and behold, it was her paper, her PowerPoint presentation, and he had only changed the names with a "find & replace" search. Unfortunately this did not catch several self-references within the paper (which he had evidently not read beforehand.) My wife notified his department head at Emory Medical School. The department head dec;lined to do anything, stating that it appeared to him that the work was substantially the physician's. The matter was referred to the Emory University Faculty Senate and the physician was allowed to run out his contract, but will not be renewed in the fall. Toooooo baaaaaad, doc!
chris,
completely wrong. Plenty of good research is done by md's. Google jonas salk
I suggest you look at pubmed for more physician-led research. Plenty of it is in the basic sciences, as well as observational AND prospective clinical trials
Your ignorance is staggering.
eric, Albert Sabin would have been a better example for your point! But then you would have to open that whole polio issue! Might try all that great research published in the early to mid 1800's, by MDs, concerning the "diseases" of slavery! But it was all later disputed, right?
I don't see that there is anything wrong with MD's doing research, but really there should be a peer review by someone with a background in probability and statistics AND medicine. Just like any other field, just because they MDs are spectacular doctors doesn't necessarily mean they can interpret the data, qualify the data, or perform any other function outside that area of expertise. It doesn't mean they can't either - but if you're going to tell the world to brush their teeth for the health of their heart, you better be bulletproof on your causality.
MrKnowItAll-2964592,
better? Why? But another good example...
If you have to go back 2 centuries to prove your point, its probably not very good, just fyi
wrecked,
Most docs take bio statistics in medical school, and many take a survey statistics course in undergrad.
If you want someone with more than that, like a masters or even a double major, keep dreaming...
Probability is not applicable at all. Come on...
@eric...
Evidently, there is some confusion. In the study of correlations (which is what this study is about), probability is a key component, especially when testing the significance of the correlation. Probability is applicable to the subject matter of this article.
Also, statistics (even Biostatistics) is probability. You cannot separate the two.
But why take my word for it. Perhaps you would like to read through the lecture notes of the Probability and Statistics Course at MIT.
Course Description Here:
http://ocw.mit.edu/courses/mathematics/18-05-introduction-to-probability-and-statistics-spring-2005/
Lecture Notes Here:
http://ocw.mit.edu/courses/mathematics/18-05-introduction-to-probability-and-statistics-spring-2005/lecture-notes/
It takes more than a couple of courses in biostatistics to properly do research.
jrs,
Im not sure what youre trying to prove by posting those links. Sure, classes in probability EXIST...never denied that. But show me that drs need to take those classes in order to understand/perform research...
By the way, you can certainly seperate the two. There are biostatistics classes, and there are probability classes at many institutions
Mark,
yeah, like undergrad and medical school--which drs do.
Not all MD's are researchers. The vast preponderance aren't. Most of them are consumers of scientific literature, and thus are inclined as anyone to accept something in a journal at face value and spend very little time reading these things critically.
I'm a researcher. I have areas of expertise, but like any researcher I rely on journals to fill in gaps in my knowledge. But I have enough skills to know if a paper's inferences space is way off.
There is a big difference between an MD and a medical researcher in terms of skill set... and I am perhaps harsh on MD's because of a few bad apples I've run across.
Now I've learned better how to better choose a doctor, and I've learned how to better converse with them about the research behind conditions. I really think I've gotten a lot more out of my doctor/patient relationship since I've taken a more active role - but the Dr's that are more receptive to my efforts are the ones with some research background.
The revelation for me was the fact that there are doctors like this who actually have/participate with general practices.
But all MD's (and dentists, BTW, since dentists participated in this research) attend undergrad, and receive education in the scientific method, research, and statistics. They are not lay people reading research - they are able to read and interpret research critically. Did all PhD candidates learn critical thinking skills ONLY in their post-graduate courses? Of course not. Same with MD's.
And when speaking of CLINICAL research, how can physicians (and other healthcare personnel) be removed from the research process? Who administers medications? Performs procedures? Assesses outcomes? There is a place for both in research - the MD and the PhD.
I'm an environmental researcher... my wife is a PhD level statistician...
I am realizing that this particular sub thread isn't quite the right fit - I mistakenly responded to comments in other sub threads
however, undergraduate courses are not equal to research credentials... they are a bare-bones foundation.
Agreed. And certainly no one is suggesting they are. Without a doubt, someone with a PhD in statistics knows far more about the field than someone who took a couple classes in college
But does that imply that ONLY PhD level statistic knowledge is required to critically analyze research papers? Hardly.
For example, premeds are usually required to take calculus, and often a statistics course in undergrad. They then take a graduate level biostatistics class in medical school (as intense as a PhD level class--no, but still not exactly childs play). Then in residency they are required to attend and participate in regular journal club meetings in which they are expected to critically assess a paper, provide valid criticisms, and be grilled by attendings (many MDs, AND PhDs, as well as md/phd faculty). Also, informally, they are assigned d to read articles and present them on rounds, often with the same expectations
Further didatics are given both sporadically and during scheduled conference time
After all this, do I understand concepts like bayes theorem, sensitivity, specificity, lead time bias, selection bias, etc etc? Yes. I'll need the assistance of a good phd statistician to help design a study, of course, but Im more than capable of interpreting it
Dont get carried away by what the media reports a study to show, and what the authors actually believe it to show. They are often two very different conclusions
When my son was born, popular medical practice said that you didn't lie a child on it's back until it could roll over on it's own, or it could spit up and literally strangle/choke on it's own vomit and hence die, being unable to breathe....blamed for SIDS. So we all put our kids on their tummies in the crib.....Fast forward to 12 years later when my daughter was born, and suddenly, you had to prop them up with ridiculous bumper contraptions as they could be neither on their back or their sides for fear of SIDS....Now supposedly, they couldn't turn their head and would suffocate in the mattress, or their own spit up. We were told to take the bumper pads, blankets, pillows...basically everything out of the crib for fear of a choking incident. ....It has been 12 years since my daughter was born-anyone out there want to tell me what the policy is for how baby is to be placed now to avoid SIDS....By the way, they still don't know what causes it despite a National Foundation for research.
Not really what the article was about, but babies should be placed on their backs to sleep. Not on their tummies. There should be no bumper pads, loose blankets, pillows, stuffed animals, etc. in the crib. "Sleep sacks" are good for keeping baby warm during cool weather, and are pretty easy to find. They don't need to be propped up.
@ eric...
In responding to your statement, I have to ask how you are trying to define probability because the statement "By the way, you can certainly seperate the two. There are biostatistics classes, and there are probability classes at many institutions", while true that there are classes with both names at the same institution, does not mean the subject matter is mutually exclusive.
For example, Biostatistics heavily involves probabilities. In most cases, you cannot perform Hypothesis testing without probabilities which is essential to understanding research results. So, understanding probabilities, even as part of a Biostatistics course, is essential to performing research.
I happen to have a Biostatistics book on my bookshelf. Chapter 5 of my Biostatistics book is entitled "Chapter 5, Probabilities". A direct quote from the first few paragraphs of this Chapter is "...aspects of probability are of biological interest and considerations of probability theory underlie the many procedures for statistical hypothesis testing discussed in the following chapters."
Statistical testing of a null hypothesis about the mean of a population involves determining the mean of a random sample from the population and then determining the probability if the null hypothesis is true. Often probabilities are referred to as the significance level. Probabilities are used to reject or accept the null hypothesis and are found in the Z-test statistic, the t-test statistic, the F-test statistic used in ANOVA, and probabilities are also used to determine Type I and Type II errors, define confidence intervals (e.g., the probability behind a 95% confidence interval), and a variety of other statistics used in Biostatistics too numerous to mention here.
"As a mathematical foundation for statistics, probability theory is essential to many human activities that involve quantitative analysis of large sets of data. Statistics is closely related to probability theory, with which it is often grouped; the difference is roughly that in probability theory, one starts from the given parameters of a total population to deduce probabilities pertaining to samples, but statistical inference moves in the opposite direction,inductive inference from samples to the parameters of a larger or total population."
In short, one cannot perform statistics without probability because primary peer-reviewed literature will generally not accept results from data that has not been statistically analyzed or verified but should have been. The way to do this is with testing that involves test statistics based on probabilities that allow one to accept or reject the null hypothesis and be confident that any tests or outcomes truly reflect the results of the study and are not an anomoly. Thus, doctors absolutely need an understanding of probability, especially within Biostatistics, to understand and perform research and to get that research published in a scientific journal.
I honestly can say i have never been involved in a more pointless and off topic discussion than this current one.
Of course statistics uses some theories of probablility. A probability CLASS is overkill for a medical researcher as they tend to be very mathmatically heavy
Did you even look at the links you posted? I took statistics and I never encountered mathmatical formulas as complex as listed in the course notes. Rarely if ever did we perform integration calculations, and never equations as complicated as that. Probability focuses more on the DERIVATION of formulas statisticians use
Statistics, on the other hand, focuses more on the application of these mathmatical ideas.
To my point, there are both statistics classes and probability classes at most institutions
Again, a probability class is overkill for a medical researcher, and and a phd researcher for that matter. It is a must for the statistician that most MDs and PhDs have on their research staff to assist in designing studies and crunching the data
You have to realize that research is a team effort, and no one person can do it all on their own. while the PhD biology person will come up with a hypothesis and conduct the research, the statistician will do most of the calculation
As I said earlier, it does not mean the PhD cannot interpret the statisticians calculations for clinically meaning...
Chris, That is the very reason that we do not publish papers. The stable of lawyers it takes to protect the work is more costly than the actual research! The patent, trademark, and copyright laws are a joke! Great Story!
Bacteria from teeth cleaning entered my dad's bloodstream, shut down his kidneys, colonized in his aortic valve and destroyed it. The bacteria was cultured and determined to be the same bacteria from his gums. While it may not cause heart disease it didn't do my dad any good either. He nearly died. Now he has to be on IV antibiotics prior to each cleaning, which he has done every 3 months. As far as I'm concerned, gum disease can cause heart problems. Maybe not heart disease or stroke but definitely other problems.
its well known that endocarditis often is seeded from oral bacteria. I don't think the article is talking about that entity.
By the way, IV antibiotics are probably overkill...the guidelines recommend nothing more than amoxicillin (a by mouth med)
Just as I suspected. I've always gotten a kick out of the mumbojumbo offered by dentists over the years. Of course, they have their reasons. In 40 years I've flossed about 12 times, have never had a cavity, and still have all my wisdom teeth. I drink coffee profusely and have a Merlot drip hooked up to me 3 days a week. Absolutely no health problems here. Leave it all to chance and stop trying to prevent the inevitable.
That's because you're too drunk to notice.
I imagine your breath would give the Fresh Kills landfill some real competition. I heartily agree that in your case you should leave it all to chance and stop trying to prevent the inevitable.
I don't care what those so called BS'ers experts say that aren't really experts at anything, other than claiming their experts at being experts ~ Badd gums and Badd Teeth can and will cause other health problems as bacteria and other infections enter the blood stream and wreak havoc on other parts of your body, from your heart, to your kidneys to the nerves etc. Also, about 99.9% of this Disasterous FAST FOOD all these Corportations are selling us as Nutritious aren't really nutritious at all, as they are loaded with all kinds of Sugars and preseratives that eat away the enamel off your teeth and eventually weaken your teeth, till they start chipping and breaking off, a lot of its the food we eat Fast food, sugary food, and the type of Job we have too, such as a job that requires long hours, meaning 12 to 16 hours a day work, or irregular shift work can also add to badd teeth and gums as well as improper rest and not getting proper rest. Also the short time employers give at work for lunch breaks such as only a 1/2 hour to Cram your food down you as fast as possible is just ridlicious and needs looking into as well. Now, how do I know All this ??? Because I only have 1 Tooth left right in the center of my mouth , 1 Tooth, and I'll tell ya, I ain't a pretty site to look at when I smile, believe me, kinda horrifying actually,, and honestly, I couldn't get a date with a Blind Girl with only having 1 Tooth right in the center of my mouth, thank God, my Dog still likes me tho, usually as I prepare her Smoked Salmon off the Bar B Q Grill. and what gives me credence to write this article ??? Because I'm a former Long Haul Truck Driver of 23 years who spent a lot of long hours driving driving all over the country and eating not the best of foods as always, Over weight I'm definetly NOT, at 6ft tall 180lbs , but I do have badd teeth, I may go to the Ocean and find me a Great White Shark and rip his Teeth out to replace mine, remember that Guy JAWS from the James Bond Movies in the 1970's, I wanna look like him and eat license plates and steel !! but right now, I only have 1 whole tooth left, I may auction it off on EBay or something,,,, any bidders ??? Over & Out ,,, they call me "TOOTHY" at work !!!
I wanted to read your post, but it's too loud.
Every high school student needs a course in statistics, with particular emphasis on temporal or casual vs. CAUSAL relationships. Just because sunrise is associated with an increase in the number of cars on the road DOESN'T mean that the sun caused the increase. They are only temporally related. And by the way, did anyone notice the related link to the article on Bad Gums linked to Erectile Dysfunction???? Now that is an article to make you stand up (no pun intended) and take notice. How did they ever get those rats to use dental floss??? And is it my imagination or is that Jim Carey flossing in the laundry mat??? LOL
For a bulletproof causality argument, review the pirates/global warming relationship at the core of Pastafarianism. It's compelling.
I think that pun was intended. You wanted to get a rise out of us..
Another excuse for the insurance and medical scammers as they continue to keep dental health out of medical insurance. Disgusting!
I have often wondered if the causality is so certain between dental work and prevention of heart disease and stroke, why it wouldn't be covered under medical insurance, because that would certainly then come under the heading of preventive medicine. However, you have to buy dental insurance separately and additionally, and it doesn't seem to cover a whole lot of anything other than x-rays and cleanings...co-pay on everything else is greater and greater, kind of as the service gets more expensive, the cost of it to the patient increases.
Based on what I have seen on medical studies over the past 50 years about 90% of them are BS.
I can not believe this article although I have not read all the reply posts. Scotlund Stivers a scientist and inventor all over the Internet with his various inventions (just GOOGLE it) including a way to turn scrap tires into diesel fuel informed me he never ever brushed his teeth. Now he has had a severe upper jaw infection no antibiotic will touch. He has been on antibiotics for many years. He went to at least 3 or 4 different oral surgeons and they refused to operate on him informing him he might die in surgery. The last one agreed but wanted him to sign a release that saved him harmless from any complications that ensued including death and possible lawsuits from surviving relatives. He wanted them to operate through the outside of his mouth when they needed to go from inside of his mouth. He went down to southern Michigan for several months undergoing hyperbaric chamber treatments in attempt to stop the infection. Nothing has helped. But he has other health issues such as weighing upwards of 475 to 550 pounds. But his jaw infection itself started when he was perhaps only at 250 pounds.
He owned the Arthur K. Atkinson 400 ft. ship (photos all over the internet) parked at the old dock in Detour, MI. for many years now it is parked at the shipyard in Sault Ste. Marie, MI. 49783 down by the Sugar Island ferry. His 2 tugboats he purchased and ferry boat sunk in the Cheboygan, MI. 49721 harbor. A huge oil spill resulted with the U. S. Coast Guard left to clean up his mess, which means of course us the U. S. taxpayers. His plan was to tow the A. K. A. over to Wisconsin where he has dockage and have his tire recyling project done on board the ship. The ship was converted from coal power to diesel power with two 3406 cat. gens. to start the main diesel.
He had his maritime Attorney H. Keith Dubois of West Branch, MI. 48661 apparently a retired highly decorated U. S. naval officer sign a bogus sworn and notarized legal document promissory note before the court for rents owed me attesting to a cemetery he owned over in Minnesota 20 acres enough for 35,000 burial plots he received $10,000.00 for each lot, total value 325 millions and that he sold $150,000.00 of the lots in 2010. It turned out to be non-existent in a decision by Magistrate Timothy Greeley Fed. (U. S. Dist.) venue court in Marquette, MI. 49855. So I am stuck with a judgment I can not collect on as his now Attorney Charles Malette of Sault Ste. Marie, MI. 49783 has skillfully hidden all his assets. And they found enough cyanide in his apartment over at the old radar base to kill one hundred thousand people. Then he took some of it in the Cheboygan, MI. 49721 court a couple weeks ago in a suicide attempt but deputies managed to get it out of his mouth in time to save his life. Anyway I feel filing false legal documents in the court may perhaps be a felony punishable by up to 5 years in Fed. prison and/or $250,000.00 in fines.
My theory: Bad gums are a sign of inflammation; inflammation can also cause heart disease and a number of other problems such as cancer and Alzheimers. One does not cause the other, it is a sign of an underlying problem that contributes to many health problems. You can go to the dentist often and keep treating your gums- as you should- but if you have the underlying inflammation your gums may look and feel better, but you still have health risks.
If you have bad gums, you probably have bad teeth. If you have bad teeth you probably have bad breath. If you have bad breath, you will have trouble attracting a companion. If you have trouble attracting a companion, you will be sad and lonely, leading to heartbreak. A broken heart will adversely affect your life and perhaps cause you to die sooner than you normally would have.
Too much death talk. We're all going to perish on Dec 21, 2012 anyways....movies never lie.
Bull! It is a long established fact that prior to the Spanish - American War and the very beginnings of antibiotics, that tooth or gum abysses were the #1 cause of death in the US as a result of sepsis that destroyed organs including the heart. They just like to write that one off so insurance companies and Medicare/Medicaid are off the hook giving dental care to prevent such health risks. The American Heart Association should be ashamed of themselves for ignoring so many prior studied that state the connection. I won't be donating any money to them in the future.